Laparoscopy, when carried out in order to determine the cause of a woman's fertility problems, is considered "diagnostic" surgery. For certain types of fertility disorders, the opportunity can be taken during the laparoscopy procedure to actually attempt to rectify the problems detected. Because of the expense and mildly invasive nature of the procedure, and due to the need for general anesthetic for the patient, laparoscopy is almost never recommended as a first stage infertility test. It is usually performed only after other, less invasive fertility tests have failed to shed any light on the reasons for a woman's problems becoming pregnant.
Sometimes, female infertility is caused by physical abnormalities in the female reproductive organs. If the ovaries, fallopian tubes or uterus are scarred, twisted or blocked in any way, this may prevent ovulation and fertilization. Eggs may be blocked from proceeding down the fallopian tubes to meet sperm cells that have entered the uterus and fallopian tubes during sex. Likewise, the sperm cells may be blocked from making their journey to the upper reaches of the female reproductive system.
There are a number of medical conditions that can cause blockages, scarring, twisting, and adhesions in the reproductive organs. These include endometriosis, PCOS, and sexually transmitted infections such as Chlamydia. The aim of the laparoscopy procedure is to look for such abnormalities and possibly put them right.
The patient is usually given general anesthetic and is therefore not conscious during the procedure.
To view what is going on inside the reproductive system, the operating surgeon needs to insert a very small telescope called a laparoscope (hence the name of the type of surgery). This telescope allows him to view the organs on a screen.
To insert the laparoscope, he makes a small cut (incision) in the lower abdomen. This cut may stretch 8 to 10 millimeters - it really is tiny. He may then pump in a small amount of gas, such as carbon dioxide, in order to create enough room for the laparoscope to move around. Then he inserts the laparoscope and starts looking for signs of any of the problems mentioned above.
If he does find some endometriosis tissue, or scarring, he has the option of trying to fix the problem then and there. However, the patient needs to have given her consent before the procedure begins for him to do this. If you're undergoing a laparoscopy, it's worthwhile, therefore, considering whether or not you'd like the surgeon to try and repair any damage he might find, and discuss this with him beforehand.
There are a number of instruments used to repair tissue damage in the ovaries, uterus and fallopian tubes. The surgeon may use a laser or he may burn away unwanted tissue using a technique called ablation. To do this, he will need to insert more surgical instruments into the abdomen via further small incisions.
There are some small risks, including infection and bleeding, involved with these processes - which you should discuss with your surgeon. This is a minimally invasive surgical procedure - therefore recovery is usually fast and patients generally go home on the same day.